What is the ideal management of Krukenberg syndrome?

We present the case of a 34-year-old female patient diagnosed with Krukenberg Syndrome, in which we performed total cytoreduction surgery of the lesions, with subsequent perioperative chemotherapy. After a follow-up of three years, we observe she continues without evidence of disease. In the early 1990's Sugarbaker et al. introduced cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) as a new innovative therapy option for selected patients with peritoneal carcinomatosis. Nowadays, there is no established treatment for patients with peritoneal metastasis of colorectal cancer. There is a need for the future high-quality randomized multicenter trials to make a strong recommendation.

Gastric perforation after blunt abdominal trauma: first case report in Argentina.

We report the case of a 18-year-old male with gastric perforation due to blunt abdominal trauma as a result of a vehicular collision. An exploratory laparotomy with suturing of the lesion and an omental patch is performed. The post-operative outcome was favorable. Traumatic injury is a frequent cause of hospital admission to the emergency department in Argentina, and vehicle collisions are the first cause of death and permanent disability in young adults. Isolated gastric perforations following blunt abdominal are an uncommon finding, and there are only a few published cases in the literature. It is interesting to discuss the type of surgical approach.

Acute appendicitis secondary to metastatic breast cancer. 12 Years after first primary tumor diagnosis. A case report.

INTRODUCTION: Metastatic adenocarcinoma to the appendix is an uncommon finding, there are few published cases in the literature of appendicitis from metastatic breast carcinoma. PRESENTATION OF CASE: A 51-year-old female was admitted to the emergency department with a presumptive diagnosis of acute appendicitis with a past medical history of stage IV Breast Cancer 12 years ago. Appendectomy was performed, finding a perforated appendix. Anatomo-pathology examination revealed a semi-differentiated carcinoma involving the tip of the appendix. DISCUSSION: Gastrointestinal tract (GIT) metastases of breast carcinoma are an uncommon finding. Appendiceal metastases are a very uncommon finding, and the interval between diagnosis of the primary carcinoma and the metastases can be many years. There are no reports about whether right hemicolectomy provides better oncological outcomes than an appendectomy in stage IV BC. CONCLUSION: There are no guidelines for the management of this disease but unquestionably, multidisciplinary management leads to better outcomes.

Multifocal Nodular Fatty Infiltration of the Liver: A Rare Benign Disorder That Mimics Metastatic Liver Disease.

Fatty liver disease is a frequent diagnosis. Rarely, it adopts a multifocal nodular pattern mimicking multiple liver metastases. Multifocal nodular fatty infiltration of the liver entails a challenging problem that must be included as a differential diagnosis when dealing with healthy patients with an incidental finding of multiple liver lesions, even in the absence of obesity or metabolic syndrome. A complete clinical examination and high-quality imaging, including magnetic resonance imaging, might help to confirm diagnosis and to avoid unnecessary liver biopsies.